Requesting disability accommodations in medical school [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“I failed my Step 1 medical school board exam by 1 point. This was very hard for me to process, and I consistently wondered if I would have passed if I had just waited an additional week. This new challenge led me to reach out to a new resource: the disability office.

Never before had I considered my medical diagnosis of endometriosis and anxiety as a ‘disability.’ I had obviously done well enough to graduate college and get into medical school. Although, I never seemed to be able to achieve top grades in my class. I had always believed this was an explanation for being less intelligent than my peers. However, the disability office helped me realize that the standardized testing system was not equitable and did not allow me to do my very best in these exams. Through this experience, I realized that I do have a disability. All a disability means is that one is not able to achieve what other people without the disability can achieve.”

Stephanie E. Moss is a medical student.

She shares her story and discusses her KevinMD article, “Requesting disability accommodations in medical school.”

Did you enjoy today’s episode?

Rate and review the show so more audiences can find The Podcast by KevinMD.

Subscribe on your favorite podcast app to get notified when a new episode comes out.

Reflect and earn 1.0 AMA PRA Category 1 CME for this episode.

Also available in Category 1 CME bundles.

Powered by CMEfy – a seamless way for busy clinician learners to discover Internet Point-of-Care Learning opportunities that reward AMA PRA Category 1 Credit(s)™. Learn more at about.cmefy.com/cme-info

Do you know someone who might enjoy this episode? Share this episode with anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Stephanie Moss. She is a medical student, and she wrote the KevinMD article “Requesting disability accommodations in medical school.” Stephanie, welcome to the show.

Stephanie E. Moss: Thank you so much for having me.

Kevin Pho: So we’ll get to the article in a little bit, but first off, can you share your story and journey to where you are today?

Stephanie E. Moss: Of course. So, like you said, I am a medical student. I’m currently a third-year medical student at Rush Medical College in Chicago, and I’m currently taking a leave of absence from medical school after having a challenge passing my Step 1 exam. Originally, I’m from Boulder, Colorado. I went to the University of Colorado in Boulder, with a degree in psychology, minoring in leadership and dance.

Kevin Pho: And tell me, in terms of your medical school journey, has it been what you expected?

Stephanie E. Moss: It definitely has not. It’s interesting, because my husband and I actually went to medical school together, so I’ve been very thankful that he and I were able to push through together and go to the same medical school, and it’s been very interesting. I’m very glad for his support going in, but it’s been really interesting to see how each of us reacts to the stress of medical school in a different way.

And I think what has really kind of taken us by surprise is really how mental and physical illnesses can affect students, not just me, but multiple medical students that I know. It was constantly hidden. We didn’t feel comfortable to express the medical challenges that we dealt with, and we didn’t really see them as impacting our academics, because we got to medical school somehow. And it was interesting then seeing how the new level of graduate college really started to impact our grades, and taking a look back and seeing what really is going on. It’s not just intelligence. There might be more that’s having an impact.

Kevin Pho: All right. You’ll be sharing a little bit more about what you’re talking about in your KevinMD article. It’s titled “Requesting disability accommodations in medical school.” Now, for those of you who get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?

Stephanie E. Moss: I’m going to take a step back, six to eight months ago, when this all happened. Just like all second-year medical students, I went into our dedicated study period, and right away I started noticing that something was off. I was struggling, for the first time, to just do studying 24/7, not have a job or any requirements. And I took practice test after practice test, and I just wasn’t getting a passing score. I had tutors and mentors and all that, and test after test, I just couldn’t get a passing score.

And so thankfully, my school allowed me to push my exam back an additional month. So I started M3 here, just like my classmates, but there was a four-week period where people could take electives, and I took that additional four weeks to continue to study, and I just still couldn’t pass the exam. And my school gave me an option of taking the exam and risking failing, or taking the year off. So I decided to take a year off.

About a couple months later, I went in for the exam, after I’d been scoring what I thought I needed, and I failed it by one point. At that time, the passing score was 194, and I got a 193. And that was so detrimental and painful for me, and I didn’t know what to do at that point.

And thankfully, I had another friend who had gone to the disability office, and I was so surprised, because I had never really thought of myself as having a disability, especially since the disabilities that I was aware of were maybe dyslexia or ADHD, ones I’d heard of. Or we also like to think of disabilities as being in a wheelchair, something like that. And after I made that decision to go to the disabilities office, everything just came into place.

The disabilities office talked to me, and I guess I didn’t disclose before, but I found in medical school that I suffered from endometriosis, infertility, anxiety, and a lot of these health conditions that I didn’t know about before I went to medical school. And now I finally have a support that’s saying, “Hey, maybe your struggle with academics, this struggle with Step, is not your intelligence,” which is unfortunately what I was constantly thinking. That imposter syndrome really hit. But then suddenly the disabilities office is saying, “No, we can help you.”

And so the letter that I wrote for KevinMD is actually a segment of the request for disabilities that I sent to the USMLE, to request additional time for breaks. And I had that approved, and it was such a challenge to be able to get to that point. And I wish so much that someone would have told me that I qualified for disabilities, not just at the beginning of med school, but years before. Through writing this article, I started to recognize different patterns that I had noticed, all the way from elementary school, that I had struggled with exams.

So that is what my article is about: how important it is, if students feel like they’re struggling constantly with exams even though they’re doing everything, why not go to the disabilities office? It doesn’t hurt. They will be honest with you and say, “No, sorry, that’s not a disability,” or you might be surprised, and you might receive support that might change the outcome of your entire medical career.

Kevin Pho: So tell me the process and what the disabilities office did for you when you first visited them.

Stephanie E. Moss: Yeah. The first visit, I met with Marie, who’s the director, and we just sat down virtually on Zoom, and I just told her a little bit of my story, what I had struggled with: getting my diagnosis, struggling during the school year, going to mental health appointments and physical health appointments in addition to studying, and having pain all the time. And I just told her what was happening, not expecting anything. And she talked to me a little bit about other students and other current physicians and residents that she had worked with, not just at our institution but across the country, and that I was not alone. And that was so meaningful, to know that it wasn’t just me. I wasn’t making up these illnesses. These were real issues, in the fact that they were affecting me.

And then the process from there, she requested that I get letters from my physicians. So I got a letter from my surgeon, who diagnosed me with endometriosis, from my therapist, who treated me for anxiety, and from the medical school primary care docs, so different physicians. And I compiled that to send to her. And then she also asked me for this letter, where I sat down over a couple weeks and just explored my journey.

Kevin Pho: And what kind of accommodations did the disability office offer you?

Stephanie E. Moss: Yeah, so I got approved for extra time in exams and extra break time when I actually go back to medical school, for any additional tests and exams. So Step, not Step 2, because that is USMLE, so the board exams, the many ones that we take at the end of each clerkship, that will be at the school, so that is in addition.

But specifically, for my Step 1 USMLE, I just requested time for additional breaks, because during the first exam, I noticed that my anxiety was so high, because I have to go to the restroom about every hour. And since the block in Step is just 40 questions in one hour, that’s enough, but I just need a little bit more extra time to maybe take medications and take breaths, more than is provided.

And then when I go into my clerkships, we’ll be requesting additional accommodations, like when I scrub in, I can only be scrubbed in for an hour and a half, and then go to the restroom or take a medicine and scrub back in, and things like that. Or in my primary care clerkship, I will need a chair. I just can’t stand for long periods of time. So similar things like that.

Kevin Pho: So in medical school in general, there’s always stigma that anything outside of the norm, you know, whether it’s behavioral health issues, it’s really kept quiet. Now, what has been your experience? How accepting, in general, has the community been when you talk openly about the disability?

Stephanie E. Moss: That’s a really good question, and it’s a huge mix. I would say older physicians, older generations, have been very difficult. They’re not direct to my face, but when I tell them, it’s just like, “Oh.” And then you can tell that there’s some negative energy that’s going on there.

But my classmates have been amazing. They’ve been reaching out to me, like, “Oh, I have this. Do you think this would be an accommodation?” “Hey, I take this medication. What do you recommend? Who should I talk to?” So I think my own classmates, my generation, are so open. They want to talk about it. And so I’m very excited for our generation of physicians, who recognize that mental health is an issue and that we’re not superheroes. Physicians, nurse practitioners, they’re not these magical beings who don’t have their own illnesses. We’re humans. And just because we have something, a mental or physical illness, doesn’t mean we can’t be a medical professional and help others.

Kevin Pho: Now, as you reflected on this, you mentioned that you may have had some of these symptoms really early on in your education journey. Now that you’ve reflected on it, is there anything that you would have done differently during your medical school journey?

Stephanie E. Moss: I would have wished that I had gone to disabilities from day one, especially when I came into medical school not knowing I suffered from anxiety. Unfortunately, I did not have the best health insurance. None of my family members are a part of medicine or have anything to do with it, and I also suffer from a very complex trauma history. So I just didn’t have access to that. So I myself didn’t know, nor accept, that I was allowed to seek help, and so that definitely had a huge impact on me not being able to get support earlier.

Kevin Pho: We’re talking to Stephanie Moss. She’s a medical student, and she wrote the KevinMD article “Requesting disability accommodations in medical school.” Stephanie, what kind of advice can you give to other medical students who may be undergoing disabilities, or a similar story to yourself?

Stephanie E. Moss: I think what’s so important is that each individual knows that they’re unique, and that’s OK. That’s why you’ve been accepted into medical school. For the medical school committee, there are thousands of individuals who apply. There’s a reason they picked you. It’s because you’re unique, and that’s OK, and you should be proud of your uniqueness.

And if that means that you need to go to therapy, you need to go to doctor’s appointments, that’s OK, and it is your right to have those appointments and receive that additional support. That also can include when there are exams coming up and you struggle to just be calm, or you struggle to answer in the amount of time. It’s OK to ask for more time. It’s OK to ask that you get more time for Step 1 if the adequate time of studying isn’t enough. And I think that’s so important, to know that you’re not alone, and there are so many individuals out there who are willing to help you.

Kevin Pho: So it sounds like your community at Rush has been tremendously accommodating, and this looks like a positive result from this. Just from what you know, from responses to your KevinMD article, has your experience been reflective of other medical institutions across the country? Have you heard any other stories from other students, similar to yourself, who may have had a different experience?

Stephanie E. Moss: I’m glad you asked that, because that is the really sad thing: This is not universal. Our school, because of our amazing disabilities office, has been really focused on advocacy, but like I said, it is so new, and a lot of medical schools and undergraduate schools have a long way to go. I received a lot of feedback from individuals all over, both in the graduate and undergraduate realm, saying, “Oh, my school says that my disability counts,” or “My medical problem isn’t severe enough to receive accommodations.” And actually, even in my own school, I’ve had individuals who have constantly struggled even getting support. So I can appreciate that this is just the beginning, and the first thing is just to know that the resource exists.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Stephanie E. Moss: I think the biggest thing that I would like individuals to take away is that chronic mental and physical illnesses are disabilities. It doesn’t have to look like a physical disability of needing a wheelchair or not being able to hear or see. These illnesses can have a significant impact on your academics and life. And so it’s important to first identify that you do have an illness, and that it is a disability, and that you deserve to receive accommodations. You deserve it. It is part of your right to at least ask for help.

And for a lot of individuals, including myself, that was such a hard thing, especially when you have a history of some sort of trauma. The idea of asking for help is really hard, because you feel like you don’t deserve it, that you’re special for even being accepted into medical school somehow. But we have to let that imposter syndrome be quiet for a little bit and advocate for ourselves, just like we advocate for our future patients.

Kevin Pho: Stephanie, thank you so much for sharing your time and insight, and thanks again for being on the show.

Stephanie E. Moss: Thank you so much.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes